Oxytocin and the social facilitation of placebo effects

Significant clinical improvement is often observed in patients who receive placebo treatment in randomized double-blind placebo-controlled trials. While a proportion of this improvement reflects experimental design limitations (e.g., reliance on subjective outcomes, unbalanced groups, reporting biases), some of it reflects genuine improvement corroborated by physiological change. Converging evidence across diverse medical conditions suggests that clinically-relevant benefits from placebo treatment are associated with the activation of brain reward circuits. In parallel, evidence has accumulated showing that such benefits are facilitated by clinicians that demonstrate warmth and proficiency during interactions with patients. Here, we integrate research on these neural and social aspects of placebo effects with evidence linking oxytocin and social reward to advance a neurobiological account for the social facilitation of placebo effects. This account frames oxytocin as a key mediator of treatment success across a wide-spectrum of interventions that increase social connectedness, thereby providing a biological basis for assessing this fundamental non-specific element of medical care.

Automated summary

Significant clinical improvement is often seen in patients receiving placebo treatment, which can be attributed to both experimental design limitations and genuine physiological changes. The activation of brain reward circuits and the warmth and proficiency demonstrated by clinicians play important roles in the observed benefits. Oxytocin and social reward are key factors in facilitating placebo effects, providing a neurobiological basis for evaluating this fundamental aspect of medical care.